US8663144B2 - Modular compression device and method of assembly - Google Patents

Abstract

An apparatus for applying pressure to a body part comprising multiple interconnectable bands of compressible or noncompressible material. Optional spine to further interconnect the bands. Interconnectable pieces designed for covering specific body areas. Modular arrangement of the individual components. Customized or off-the-shelf availability of the apparatus.

Description

This application claims the benefit of U.S. Ser. No. 60/555,150 filed Mar. 22, 2004, the disclosure of which is hereby incorporated by reference.

BACKGROUND

Excessive interstitial fluid accumulation, referred to as edema, may arise from a variety of illnesses and conditions, including venous valvular insufficiency, postphlebotic syndrome, and lymphedema. Control of this edema by reduction of interstitial fluids is important to increase PO2 delivery to tissues, relieve pain from swelling, and decrease risk of infection. Decreasing drainage of fluid from sores, skin breaks, and/or ulcerations promotes wound closure, prevents wound breakdown, and decreases risk of blood clot formation in veins.

Thus, it is desirable to have a customizable or off-the-shelf compressive device that can be readily available for application to a body part to prevent excessive fluid accumulation resulting from a variety of diseases and maladies.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an illustration of one embodiment of a modular compression garment according to the present disclosure.

FIG. 2 is a perspective view of a band used in the modular compression garment ofFIG. 1.

FIG. 3 is a break-away view of the compression garment ofFIG. 1 including one embodiment of a spine used for connecting a plurality of bands such as those shown inFIG. 2.

FIGS. 4 and 5 are alternative embodiments of a modular compression garments of the present invention.

FIG. 6ais a side perspective view of a footpiece for use with a modular compression garment.FIG. 6bis a block diagram of the compression garment, including in one embodiment the footpiece ofFIG. 6a.

FIG. 7 is a side view of a liner for use with a modular compression garment.

FIG. 8 is an illustration of an order form for ordering a customized compression garment.

DETAILED DESCRIPTION

The present disclosure relates generally to treatment of edema and, more specifically, to a device for applying compressive pressure to a person's body in order to facilitate reduction of interstitial fluids from a body trunk and/or limb extremity and to provide support and fatigue relief.

It is to be understood that the present disclosure provides many different embodiments, or examples, for implementing different features of various embodiments. Specific examples of components and arrangements are described below to simplify the present disclosure. These are, of course, merely examples and are not intended to be limiting. In addition, the present disclosure may repeat reference numerals and/or letters in the various examples. This repetition is for the purpose of simplicity and clarity and does not, in itself, dictate a relationship between the various embodiments and/or configurations discussed. Moreover, the formation of a first feature over or on a second feature in the description that follows may include embodiments in which the first and second features are formed in direct contact, and may also include embodiments in which additional features may be formed interposing the first and second features, such that the first and second features may not be in direct contact.

FIG. 1 illustrates one embodiment of the present disclosure applied as a lowerlimb compression garment100. In this embodiment, the lowerlimb compression garment100 includesseveral bands102 that are of adjustable size by way ofattachment mechanisms104 for conforming, in the present embodiment, to ahuman leg106. The lowerlimb compression garment100 also includes ananklet108 for conforming to a human ankle.

It is understood that the present invention is not limited to use with the leg, but can be used in various limbs and trunks of humans. It is further understood the invention is not limited to humans, but may apply for veterinarian use such as for a horse, dog, or other animal. For example, another embodiment may be used to compress an entire leg or arm of a human or a leg of a horse or dog. Various embodiments of the present disclosure may also provide for maximal access to a portion of a limb. These embodiments may have thecompression band102 over the affected area on top, with the proximal and distal compression bands underlapping. This may allow removal of a compression band orbands102 over the affected area, while not requiring removal of the entire garment. Thus, the rest of thegarment100 may remain therapeutic while the area is accessed.

TheBands102 andAttachment Mechanisms104

Referring also toFIG. 2, thebands102 may include aninner layer114 and anouter layer112 with optional elastomericcompression material layer110. In one embodiment anelastomeric loop material112 such as Shelby Elastics Mon-3 or WonderWrap (Shelby, N.C.) may be sewn onto a backing ofelastomeric fabric114 such as Schoeller® Prestige 58012 (Sevelen, Switzerland). Theelastomeric fabric114 may be sewn on-the-bias so as to provide more stretch. For higher compression for a given amount of stretch, thefabric114 may be sewn not-on-the-bias. Therefore sewing a highlyelastic loop fabric114 onto the backing of thematerial110 may alternate percentage stretchability and alternate the compression gradient, based upon material selection and if it is sewn on-the-bias or not on-the-bias. Sewing suchelastomeric fibers114 on-the-bias may allow more stretch but less compression. For example, sewing the WonderWrap on the Schoeller fiber on-the-bias may result in a 20-30% elastomeric range with good compression. Sewing the WonderWrap on the Schoeller fiber not on-the-bias may result in a 15-20% elastomeric range with more compression. This way several embodiments can be easily engineered to provide different common classes of compression such as 8-15 mm, 15-20 mm, 20-30 mm, 30-40 mm, or 40+mm. This may allow thegarment100 to be applied lightly or tighter and more therapeutic. If applied past the range of the therapeutic stretch, then the compression applied may be directly proportional to that the user applies.

In other embodiments, a thinsemi-compressible layer110 is provided between aninner layer114 and theouter layer112 of thebands102. Thislayer110 may be made of polyurethane foam such as Rosidal Soft (Lohmann Rauscher Neuwied, Germany). Such foam would ideally by 0.3 cm thick, although other ranges of thickness 0.05 cm to 5 cm are possible. Thelayer110 may include particles made of compressible, high resiliency, low density, open cell plastic foam. Such particles ground up and of different particle sizes and shaped particles can create areas of high pressure areas and intersecting networks of low pressure areas at the seams. Use of such particles for compression garments is known in the art and sold as the Tribute™ (Solaris Inc. Brookfield, Wis.). Other materials for thecompressible layer110 may include rubber, plastic air bubbles, foam air bubbles, or non-convolute foam. Thesemi-compressible layer110 may have channels sewn in them to create lines of natural lymph flow or criss-cross pattern. Alternatively, in other embodiments the foam may serve as the inner layer with a loop-compatible fabric or elastomeric material as the outer layer.

In still other embodiments, thebands102 may not be multi-layered, as described above, but consist essentially of elastomeric yarns, for example, PowerNet™ nylon or nylon/spandex, ComfortWeave™ polyester/spandex, Clearspan® spandex manufactured by Radici, Dorlastain® spandex manufactured by Bayer, Lycra® spandex manufactured by DuPont, and any other spandex yarn, or special woven cotton fabrics such as Comprilan® short-stretch bandage, manufactured by Beiersdorf AG. Another elastomeric compression material that may be used is Lovetex® Industrial Corporation Breathe Freely (Taipei, Taiwan). It is understood in the spirit of the disclosure that any suitable elastic material may be used and is not limited to those listed above. In the present example, the chosen material would be in a range of 15% to 100% elastic stretch, although other ranges are anticipated.

In still other embodiments, theband102 may include the elastomeric semi-compressible layer and a thin outer layer of Velcro® (hook and loop) compatible fabric. Such a garment may be sold as a reusable, semi-disposable, or disposable garment. For example, as single-use embodiment might be sold sterile and for application directly after surgery on an affected limb in order to control swelling and prevent wound dehiscence, or to allow selective access postoperatively to access directly over incision or wound, while leaving rest of garment in tact. Other single-uses may include general hospital use or as outpatient clinic or home use in order to reduce or control interstitial edema. Alternative uses may be to hold a bandage or medication against a limb member.

Theattachment mechanisms104, which is connected to or connectable to thebands102, allow the bands to interconnect to one another. Theattachment mechanisms104 can be of various types such as hooks, snaps, buttons, and glue/adhesive, and some mechanisms for somebands102 may be different than those for other bands on thesame garment100. In the example ofFIG. 2, the attachment mechanisms include a hook-and-loop fastener, such as a Velcro® strip. Eachband102 may fasten to itself in such a way as the user can apply the band under compression and it will hold the compression against the body part. The hook of the hook-and-loop fastener may be sewn onto one end of the band and the body of the band or a portion thereon may have the loop material.

In this embodiment, some or all of theexterior surfaces112 of thebands102 may include elastomeric loop material. The material therefore may interlock with the hook material of theattachment mechanisms104 and/or a spine (discussed below). The use of loop material along theoutside layer112 of theband102 allows each band to apply to a wider range of compression. Also, the use of elastomeric loop material may allow the dual function of attachment to the other end of the band, which has hook material, as well providing active compression.

In varying embodiments, thebands102 interconnect to each other in a temporary, semi-permanent, or permanent manner. The connections may use chemical, thermal, or mechanical bonds. Mechanical temporary and semi-permanent bonds may include hook and loop, snaps, button and button-holes, or ties and eyelets. Mechanically bonded permanent attachments may include methods such as sewing and stapling. Chemical bonding includes methods such as fabric glue and super glue. Such glue is well-known in the art and used extensively in the industry for upholstery, furniture, and other products. Other forms of chemical bonding include tape adhesive such as PEELnSTICK and the acid-free acrylic double-sided adhesive SuperTape (Therm O Web, Wheeling II). Thermal bonding may include iron-on interfacing, ultrasonic welding of compatible components, or thermal melting of compatible components or iron-on interfacing. Such iron-on interfacing may for example include one or more layers of HEATNBOND® Ultrahold (Them O Web, Wheeling II). Some of the bonds (e.g., hook and loop) allow thegarment100 to be reused many times. Other bonds (e.g., fabric glue) may allow thegarment100 to be reused only a certain number of times. For example, the fabric glue may be reusable for a period of days, but afterwards may loose its adhesion properties. Still other bonds (e.g., thermal welding) are for a single use.

For example, alower perimeter114a(towards the foot in the present embodiment) of theinterior layer114 may include a relatively soft hook material. Thesoft hook material114amay overlap on theband102 immediately below, thus interlocking between the adjacent bands and providing additional stability of the device. Alternatively, anupper perimeter112a(away from the foot in the present embodiment) of theouter layer112 may include hook material. The lowest band may attach to loop material sewn onto theanklet108 or attach to the elastomeric loop band at the top of the footpiece. In some embodiments, there will be no soft hook material at the facing edges of the bands and the bands will simply overlap each other with the lowest band overlapping an anklet or footpiece.

Small geographic symbols may be drawn or printed on eachband102 which will change shape in a characteristic way when the proper compression is applied so that the user knows the prescribed therapeutic compression is being applied. Such symbols are well known in the art, and are applied currently to short-stretch bandages such as sold by SSL International PLC under the trade name of Setopress (London, England). In another embodiment, material color or material markings will differentiate different bands of varying levels of compression.

TheSpine120

Referring now toFIG. 3, in one embodiment, thebands102 are joined together at aspine120. Thebands102 can be joined to thespine120 in various manners, and in the present embodiment they are sewn together. Thespine120 may comprise non-elastic or elastic material. There may be no difference in bulk or therapeutic application of this embodiment. Furthermore, thebands102 may be partially or completely sewn together. In this embodiment, thebands102 andspine120 may be separately pre-manufactured, and then sewn together once measurements are made of the affected limb. By modifying the degree of overlap of the bands and the number of bands, a wide geometry of limbs may be fitted. The anklet108 (FIG. 1) may be sewn to either or both of thespine120 and theadjacent band102.

In the embodiment ofFIG. 3, thespine120 extends both on an inside (adjacent the leg) and outside (external) of the lowerlimb compression garment100. In furtherance of the example, thespine120 includeshook material122 for engaging withloop material124 on the bands102 (the loop material can be on both the inside and outside portions of the bands). Anouter layer126 is also provided, which may be either relatively stiff or rigid, which can facilitate the assembly and fitting of the lowerlimb compression garment100, or may have elasticity which can facilitate the movement of the lower limb compression garment once in place.

Other embodiments may use one spine, one on the inside or one on the outside. Other embodiments may forego the spine as the hook-and-loop fastener or other connective means lengthwise centrally in eachband102 and overlapping may provide adequate connection to hold the device together as a single unit for application or storage.

In some embodiments, thespine120 may also serve to connect the anklet108 (FIG. 1). In other embodiments, thebands102,spine120, and/oranklet108 can be attached using other mechanisms, such as glue or adhesive, snaps, or buttons. Furthermore, thespine120 can be sewn or otherwise segregated intoincrements128 so that it can easily be cut or shortened, as needed. For a lower limb, the spine may be 12, 13, 14, or 15 inches in length with increments, although single lengths of spine for different uses are within the scope of the present disclosure. For use as an upper limb compression device, for example, the spine may preferentially go the entire length of the arm along the outside edge. This may necessitate a longer spine and such permeations are within the scope of the present disclosure. Additionally, the spine may wrap around from one side to the other to allow for attachment of excess length or for additional stability of the device. Additionally, it is understood that other modular configurations exist within the scope of the present disclosure, such as any other attachment of the spine to the compression bands or method of attachment of one band to another. These may include buttons, snaps, zippers, or other methods of attachment.

Referring now toFIG. 4, in another embodiment, there are two bands, designated102a,102b, for each band “level.” Thesebands102a,102binterconnect to each other and/or thespine120. The spine may includeslits120ato assist in interconnection of thegarment100. The interconnectivity of thespine120 to thebands102a,102bmay be any method of mechanical, chemical, or thermal. In yet another embodiment, a single band (102,FIG. 1) can be fed through theslits120ato position each band on thespine120.

Referring toFIG. 5, in yet another embodiment, thespine120 includeshorizontal slits120band anoptional cover member129. Thebands102 fit against thespine120 and may or may not attach atpositions122afor the spine and112bfor the band. Thecover member129 can then be weaved in and out of theslits120bin order to hold the bands against the spine. Thecover member129 may attach just at the ends, or may attach at locations between eachband102. Again, any interconnections may be temporary or permanent and may include mechanical, chemical, or thermal bonds or a combination thereof.

Not all of thebands102 need to be similarly constructed. For example, one of the bands inFIG. 5, designated withreference numeral102c, is formed as a chevron, connecting with thespine120 at the apex of the chevron. Such shape of a band may be desirable to create a more ergonomic angle on the limb. Such angles are preferably applied perpendicular to the skin, with more angle around the upper and lower curves of the calf than the rest of the garment. Such angles may vary according to limb geometry and garment size. Also, different bands can have different levels of elasticity. This would allow thegarment100 to be placed in different scenarios, such as over a bladder used for pneumatic pumps for preventing deep veinous thrombosis. Also different levels of compression can be provided forbands102 nearer the ankle (or wrist, or shoulder) than further away from the ankle. This selection of a specific elasticity can therapeutically treat edema or decreasing vein size to prevent blood clots.

Furthermore,bands102 can have different amounts of compressions and expansion, either compared to each other or different amounts along the band itself. Using different levels of compression may be desirable for different garments. Further, graduated compression may be accomplished by using bands of various levels of compression in the same garment. For example, generally more compression may be desired in the ankle portion and less proximally for a leg compression garment. By using different band composition to vary the stretch, different levels of compression may be achieved. In another example, a band may have less stretch in the portions that intersect thespine120, and more compression near the ends that are used for thelocking mechanism104. Thus, an assembled device can therapeutically apply varying levels of compression. When the user feels that the band no longer stretches (which is considered end-stretch or near end-stretch), then the compression becomes different and proportional to the tension placed on the band. The user can thus learn to “dial in” to this difference and so more reliably and predictably apply the desired level of compression. By varying the length and width of a band and/or the composition of the band, any desired level of compression can be created in the band.

TheAnklet108

Referring again toFIG. 1, theanklet108 can be configured as a sock or stocking, being relatively thin so that a shoe can be worn over the garment. In one embodiment, theanklet108 is made of a synthetic stretch-fiber fabric such as a Lycra® brand material. In some embodiments theanklet108 may or may not fasten to the rest of thegarment100. For example, a compression anklet can be used and placed in position with, but not attached to, thegarment100.

Referring now toFIG. 6a, in another embodiment, afootpiece130 can be used as a different kind of anklet. In one embodiment, thefootpiece130 includes an inner sock-like member132 of cotton/Lycra blend and threeouter bands134a,134b,134cof elastomeric material. Other materials and construction can be chosen in order to alter the compression level of the device. Construction may be made of same materials and layers as inFIG. 2. In some embodiments, the material may be an elastic or non-elastic material and of one single layer or many overlapping layers.

The threeelastomeric bands134a,134b,134care arranged so that the firstelastomeric band134afastens over the forefoot, the secondelastomeric band134bis angled at approximately ninety degrees to the surface of the midfoot, and the thirdelastomeric band134cis fastened parallel to the back of the Achilles. In the present embodiment, the thirdelastomeric band134cis unique from the other two in that it can attach in place across, or across and downward onto the dorsum of the footpiece. Thus the design is unique in that it allows to fit a variety of foot sizes and to apply variable compression as desired to be most therapeutic.

Thefootpiece130 also includes asingle band134csewn in place in the middle with both free ends with sewn hook material. The hook material may be fastened circumferentially across just below the ankle, or may reach down toward the forefoot and across to the opposite side, for example. The flexibility of this band allows a number of geometries to be accounted for. In one embodiment, the band is just over three inches wide. The length of the band may be any desired length for therapeutic use. For example, lengths of 6 inches, 8 inches, 10 inches, 12 inches, 14 inches, 16 inches, and 18 inches, or other lengths are possible.

Referring now toFIG. 6b, as discussed above, thegarment100 can include a plurality ofbands102 and afootpiece130. In another embodiment, thegarment100 can include a plurality ofbands102 andknee piece130. In yet another embodiment, thegarment100 can include a plurality ofbands102 andelbow piece130.

Stockings and Liners

Referring toFIGS. 1 and 6, astocking liner140 may be provided under thegarment100 to reduce itching and minimize effects of overlapping on the skin. The liner can extend the entire length of thegarment100, including anyankle108 orfoot piece130, or may cover only a portion thereof. Theliner140 can be formed of a cotton/Lycra® blend or other material and may have a foam lining. The foam lining may include sewn channels to follow the body's natural lymphatic drainage lines. The foam lining also may have foam with stitches or carved portions to create a waffle-like pattern in order to facilitate lymphatic drainage in the un-compressed portions. The thickness of such aliner140 may be quite thick, such as can be achieved with the JoviPak UE-P-AG1 (Tri-D Corporation Kent, Wash.). The foam may include a granular-type material. A fabric cover may also be included on all or part of the foam lining.

Referring also toFIG. 7, theliner140, shown here being used with an arm compression garment, would have a multiplicity of pressure-applying resilient protrusions, orhigh pressure areas142 andchannels144 there between. Thechannels144 potentially facilitate lymphatic drainage while reducing interstitial edema along thehigh pressure areas142. Theliner140, which may be constructed similarly to commercial products known under the brand JoviPak, Tribute™ or Komprex II, may be a cotton or blended material with thicker woven fabric as seen in many commercially available socks.

Another embodiment of theliner140 may include one or two layers of cotton or cotton/Lycra blend or another similar woven or formed material, with semi compressible material woven between the inner and out layers of the liner. Theliner140 may also include thechannels144 which are in the form of sewn pockets withopenings146 for insertion of asemi-compressible insert148 to form thehigh pressure areas142. Such an embodiment may have distinct advantages over other commercially available liners since it may be much thinner but with similar performance. This allows more comfort for long-term wear and improved breathability of theliner140. Theliner140 may be designed for a specific use, but may have additional uses under other commercially available compression devices, such as The Cinch (Innovative Medical Solutions, Seattle Wash.), ReidSleeve (Peninsula Medical Inc., Scotts Valley Calif.), short-stretch or medium-stretch bandages, CircAid (San Diego Calif.) or other commercially used products for treatment of edema, venous and lymphedema. Theinsert148 is preferentially thin and less than 1 cm, although larger sizes may also be desirable.

In another embodiment, foam padding can be positioned in-between theliner140 and thestraps102. The foam padding can be used to reduce lymphedema. One possibility is to use dense foam such as Komprex foam (Lohmann Rauscher Neuwied, Germany). In this embodiment, the foam is cut into small squares of 0.25 cm to 2 cm along each side. These squares may or may not have a pyramid shape facing the inner layer. These pyramid-shaped areas massage the affected area during wear and can break up fibrotic areas, effectively reducing lymphedema long-term. Alternatively, one solid piece of foam with a grid but out on one side may achieve the same function. Other foam padding includes JoviPak Multi-Purpose pads (Tri-D Corporation Kent, Wash.) or other commercially available products such as the Jovi Le-C-Advi sheet foam liner. Such pads are sewn chips or pieces of polyurethane or similar foam and may or may not have channels sewn into place.

Business Method

Referring now toFIG. 8, thegarments100 discussed above can be provided in response to receiving acustomer order form200. Theform200 includes anorder information section202, ashipping information section204, abilling information section206, ameasurement section208, and ameasurement guide210. A customer can obtain and fill out theform200 where measurements are taken of key components of the affected limb. If the place of assembly for thegarment100 is the same as the place of sale, then the measurements may be compared to pre-stocked components and the proper number and type of components can be selected. The modularity of thegarment100 facilitates a sales facility in having a reduced inventory yet still being able to provide a highly-customized solution.

Furthermore, the amount of overlap of bands may be varied to accommodate a variety of leg lengths. In one embodiment, thebands102 are just over three inches in height, and each lower limb compression device may have 4-6 bands, one to twospines120, and a footpiece oranklet108. Since thespine120 may be modular, one spine may accommodate an arm or a lower leg. Other spines, such as for an entire lower limb device, may also be provided. In another embodiment, thespine120 may include a material backing with iron-on interfacing. This will allow quick permanent assembly of a plurality ofbands102 with or without an anklet. This customization can be done at the time of measurement of the actual limb, or can be done at a remote location using themeasurement form200.

In some embodiments, one or more of thebands102 can be overlapped and connected (e.g. sewn together) prior to delivering to a doctor or patient. In other embodiments, some or all of thegarment100 can be sterilized prior to delivery.

Some embodiments of theform200 can include information that would allow a doctor or provider to custom selectcertain bands102 for different purposes. For example, different levels of edema (e.g., minimal, extreme) can be addressed by selecting an appropriate elasticity of thebands102. Also, the height and/or weight of a patient can factor into the selection of band size, placement (e.g., more elastic bands near the ankle) and composition. Thebands102 can include a marker such as a position number that will indicate their placement on thespine120.

The foregoing has outlined features of several embodiments according to aspects of the present invention. Those skilled in the art should appreciate that they may readily use the present disclosure as a basis for designing or modifying other processes and structures for carrying out the same purposes and/or achieving the same advantages of the embodiments introduced herein. Those skilled in the art should also realize that such equivalent constructions do not depart from the spirit and scope of the present disclosure, and that they may make various changes, substitutions and alterations herein without departing from the spirit and scope of the present disclosure.

Claims (1)

What is claimed is:

1. A garment for providing compressive force to a limb, the garment comprising:

a first band configurable to wrap around a first portion of the limb; and

a second band having a lateral portion being juxtaposed to a lateral portion of the first band, the second band being configurable to wrap around a second portion of the limb; the first and second bands comprising bands having extension properties of short stretch material with a maximum elastomeric range of extension of 15% up to 100% of an unextended condition and are mechanically constructed and arranged relative to each other to repeatably apply a desired therapeutic compression level to the limb when applied about the body portion in a condition where the band no longer stretches, wherein the repeatable desired compression level is a level within the range of 8-40 mm compression; wherein the first band comprises a first layer of fabric material and a second layer of fabric material, the first layer being an elastomeric fabric and the second layer being a limited stretch or woven fabric, the first layer being permanently attached to the second layer to secure the layers together, such that the limited stretch or woven fabric stretches with the elastomeric fabric; and wherein the second band comprises a first layer of material and a second layer of material, the first layer being an elastomeric fabric and the second layer being a limited stretch or woven fabric, the first layer being permanently attached to the second layer to secure the layers together, such that the limited stretch or woven fabric stretches with the elastomeric fabric.

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